Effect of evidence-based clinical decision support on the use and yield of CT pulmonary angiographic imaging in hospitalized patients

Radiology

Volumn 276, Issue 1, 2015, Pages 167-174

  Dunne, Ruth M ^a   Ip, Ivan K ^a   Abbett, Sarah ^a   Gershanik, Esteban F ^a   Raja, Ali S ^a   Hunsaker, Andetta ^a   Khorasani, Ramin ^a  

^a BRIGHAM AND WOMEN S HOSPITAL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; AGED; ARTICLE; COMPUTED TOMOGRAPHIC ANGIOGRAPHY; DECISION SUPPORT SYSTEM; DIAGNOSTIC VALUE; FEMALE; HEALTH CARE QUALITY; HOSPITAL PATIENT; HUMAN; IMAGE ANALYSIS; LUNG EMBOLISM; MAJOR CLINICAL STUDY; MALE; MEDICAL HISTORY; PRIORITY JOURNAL; PULMONARY HYPERTENSION; RADIATION EXPOSURE; ACUTE DISEASE; ANGIOGRAPHY; COMPUTER ASSISTED TOMOGRAPHY; EVALUATION STUDY; EVIDENCE BASED MEDICINE; HOSPITALIZATION; MIDDLE AGED; PROCEDURES; PULMONARY ARTERY; RADIOGRAPHY;

ACUTE DISEASE; ANGIOGRAPHY; DECISION SUPPORT SYSTEMS, CLINICAL; EVIDENCE-BASED MEDICINE; FEMALE; HOSPITALIZATION; HUMANS; MALE; MIDDLE AGED; PULMONARY ARTERY; PULMONARY EMBOLISM; TOMOGRAPHY, X-RAY COMPUTED;

EID: 84937039167     PISSN: 00338419     EISSN: 15271315     Source Type: Journal    
DOI: 10.1148/radiol.15141208     Document Type: Article

References (31)

1. Brenner DJ, Hall EJ. Computed tomography - an increasing source of radiation exposure. N Engl J Med 2007;357(22):2277-2284.
2. Sodickson A, Baeyens PF, Andriole KP, et al. Recurrent CT, cumulative radiation exposure, and associated radiation-induced cancer risks from CT of adults. Radiology 2009;251(1):175-184.
3. Office of the National Coordinator for Health Information Technology (ONC), Department of Health and Human Services. Health information technology: standards, implementation specifications, and certification criteria for electronic health record technology, 2014 edition; revisions to the permanent certification program for health information technology. Final rule. Fed Regist 2012;77(171):54163-54292.
4. Blumenthal D. Launching HITECH. N Engl J Med 2010;362(5):382-385.
5. Khorasani R. Computerized physician order entry and decision support: improving the quality of care. RadioGraphics 2001;21(4):1015-1018.
6. Harpole LH, Khorasani R, Fiskio J, Kuperman GJ, Bates DW. Automated evidence-based critiquing of orders for abdominal radiographs: impact on utilization and appropriateness. J Am Med Inform Assoc 1997;4(6):511-521.
7. Ip IK, Schneider LI, Hanson R, et al. Adoption and meaningful use of computerized physician order entry with an integrated clinical decision support system for radiology: ten-year analysis in an urban teaching hospital. J Am Coll Radiol 2012;9(2):129-136.
8. Vartanians VM, Sistrom CL, Weilburg JB, Rosenthal DI, Thrall JH. Increasing the appropriateness of outpatient imaging: effects of a barrier to ordering low-yield examinations. Radiology 2010;255(3):842-849.
9. Blackmore CC, Mecklenburg RS, Kaplan GS. Effectiveness of clinical decision support in controlling inappropriate imaging. J Am Coll Radiol 2011;8(1):19-25.
10. Raja AS, Ip IK, Prevedello LM, et al. Effect of computerized clinical decision support on the use and yield of CT pulmonary angiography in the emergency department. Radiology 2012;262(2):468-474.
11. Wasser EJ, Prevedello LM, Sodickson A, Mar W, Khorasani R. Impact of a real-time computerized duplicate alert system on the utilization of computed tomography. JAMA Intern Med 2013;173(11):1024-1026.
12. Ip IK, Schneider L, Seltzer S, et al. Impact of provider-led, technology-enabled radiology management program on imaging. Am J Med 2013;126(8):687-692.
13. Shinagare AB, Ip IK, Abbett SK, Hanson R, Seltzer SE, Khorasani R. Inpatient imaging utilization: trends of the last decade. AJR Am J Roentgenol 2014;202(3):W277-W283.
14. Remy-Jardin M, Pistolesi M, Goodman LR, et al. Management of suspected acute pulmonary embolism in the era of CT angiography: a statement from the Fleischner Society. Radiology 2007;245(2):315-329.
15. Drescher FS, Chandrika S, Weir ID, et al. Effectiveness and acceptability of a computerized decision support system using modified Wells criteria for evaluation of suspected pulmonary embolism. Ann Emerg Med 2011;57(6):613-621.
16. Prologo JD, Gilkeson RC, Diaz M, Asaad J. CT pulmonary angiography: a comparative analysis of the utilization patterns in emergency department and hospitalized patients between 1998 and 2003. AJR Am J Roentgenol 2004;183(4):1093-1096.
17. Smith-Bindman R, Miglioretti DL, Johnson E, et al. Use of diagnostic imaging studies and associated radiation exposure for patients enrolled in large integrated health care systems, 1996-2010. JAMA 2012;307(22):2400-2409.
18. Wiener RS, Schwartz LM, Woloshin S. When a test is too good: how CT pulmonary angiograms find pulmonary emboli that do not need to be found. BMJ 2013;347:f3368.
19. Wells PS, Ginsberg JS, Anderson DR, et al. Use of a clinical model for safe management of patients with suspected pulmonary embolism. Ann Intern Med 1998;129(12):997-1005.
20. Stein PD, Fowler SE, Goodman LR, et al. Multidetector computed tomography for acute pulmonary embolism. N Engl J Med 2006;354(22):2317-2327.
21. Choosing Wisely: An Initiative of the ABIM Foundation. http://www.choosingwisely.org/doctor-patient-lists/. Accessed April 15, 2014.
22. NQF IEP-005-10: Candidate measure for pulmonary CT imaging for patients at low risk for pulmonary embolism. http://www.brighamandwomens.org/Departments-and-Services/emergencymedicine/Quality-Improvement.aspx?sub=0. Accessed February 2, 2014.
23. Venkatesh AK, Kline JA, Courtney DM, et al. Evaluation of pulmonary embolism in the emergency department and consistency with a national quality measure: quantifying the opportunity for improvement. Arch Intern Med 2012;172(13):1028-1032.
24. Bates DW, Kuperman GJ, Wang S, et al. Ten commandments for effective clinical decision support: making the practice of evidence-based medicine a reality. J Am Med Inform Assoc 2003;10(6):523-530.
25. Lee J, Kirschner J, Pawa S, Wiener DE, Newman DH, Shah K. Computed tomography use in the adult emergency department of an academic urban hospital from 2001 to 2007. Ann Emerg Med 2010;56(6):591-596.
26. Mamlouk MD, vanSonnenberg E, Gosalia R, et al. Pulmonary embolism at CT angiography: implications for appropriateness, cost, and radiation exposure in 2003 patients. Radiology 2010;256(2):625-632.
27. Hoo GW, Wu CC, Vazirani S, Li Z, Barack BM. Does a clinical decision rule using D-dimer level improve the yield of pulmonary CT angiography? AJR Am J Roentgenol 2011;196(5):1059-1064.
28. Bruinstroop E, van de Ree MA, Huisman MV. The use of D-dimer in specific clinical conditions: a narrative review. Eur J Intern Med 2009;20(5):441-446.
29. Kruip MJ, Söhne M, Nijkeuter M, et al. A simple diagnostic strategy in hospitalized patients with clinically suspected pulmonary embolism. J Intern Med 2006;260(5):459-466.
30. Wells PS, Anderson DR, Rodger M, et al. Excluding pulmonary embolism at the bedside without diagnostic imaging: management of patients with suspected pulmonary embolism presenting to the emergency department by using a simple clinical model and d-dimer. Ann Intern Med 2001;135(2):98-107.
31. Gupta A, Raja AS, Khorasani R. Examining clinical decision support integrity: is clinician self-reported data entry accurate? J Am Med Inform Assoc 2014;21(1):23-26.